Skip to main content

Advertisement

SpringerLink
Log in

The major determinants of arterial stiffness in Korean patients with rheumatoid arthritis are age and systolic blood pressure, not disease-related factors

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Patients with rheumatoid arthritis are at increased risk of cardiovascular morbidity and mortality. This study was undertaken to investigate the prevalence of peripheral arterial disease, and to identify factors, especially those related to rheumatoid arthritis, influencing arterial stiffness in Korean patients with rheumatoid arthritis. A total of 262 patients with rheumatoid arthritis managed in a tertiary clinic were included. Ankle–brachial index and brachial–ankle pulse wave velocity were measured. Rheumatoid arthritis-related factors were determined, as well as the traditional cardiovascular risk factors. The prevalence of peripheral arterial disease was only 1.5%. Mean pulse wave velocity was 1,559 ± 354 cm/s. Age, body mass index, blood pressure, lipid profile, and glucose, not rheumatoid arthritis-related factors such as disease duration, seropositivity and disease activity, were significantly correlated with pulse wave velocity. Moreover, stepwise multiple regression analysis revealed that only age over 65 (OR = 9.1, 95% CI 4.3–19.1, P < 0.001), systolic blood pressure over 140 mmHg (OR = 15.7, 95% CI 7.4–33.1, P < 0.001), and corticosteroid use (OR = 2.1, 95% CI 1.03–4.3, P = 0.04) were independent risk factors for high pulse wave velocity. The prevalence of peripheral arterial disease in Korean patients with rheumatoid arthritis is very low. Among the many factors related to arterial stiffness, only old age, high systolic blood pressure, and, to a certain extent, corticosteroid use appear to be major determinants, especially in clinical setting with relatively well controlled patients with rheumatoid arthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Van Doornum S, McColl G, Wicks IP (2002) Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis? Arthritis Rheum 46:862–873

    Article  PubMed  Google Scholar 

  2. Carroll L, Hannawi S, Marwick T, Thomas R (2006) Rheumatoid arthritis: links with cardiovascular disease and the receptor for advanced glycation end products. Wien Med Wochenschr 156:42–52

    Article  PubMed  Google Scholar 

  3. Smith FB, Lee AJ, Price JF, van Wijk MC, Fowkes FG (2003) Changes in ankle brachial index in symptomatic and asymptomatic subjects in the general population. J Vasc Surg 38:1323–1330

    Article  PubMed  Google Scholar 

  4. Kweon SS, Shin MH, Park KS, Nam HS, Jeong SK, Ryu SY et al (2005) Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly Koreans. J Korean Med Sci 20:373–378

    Article  PubMed  Google Scholar 

  5. Rincón ID, Haas RW, Pogosian S, Escalante A (2005) Lower limb arterial incompressibility and obstruction in rheumatoid arthritis. Ann Rheum Dis 64:425–432

    Article  PubMed  Google Scholar 

  6. Pieringer H, Stuby U, Pohanka E, Biesenbach G (2010) Arterial stiffness in a muscular artery in women with longstanding rheumatoid arthritis compared with healthy controls and patients with traditional cardiovascular risk factors. Rheumatol Int 30:1335–1339

    Article  PubMed  Google Scholar 

  7. Pieringer H, Pichler M (2011) Cardiovascular morbidity and mortality in patients with rheumatoid arthritis: vascular alterations and possible clinical implications. QJM 104:13–26

    Article  PubMed  CAS  Google Scholar 

  8. John H, Toms TE, Kitas GD (2011) Rheumatoid arthritis: is it a coronary heart disease equivalent? Curr Opin Cardiol 26:327–333

    Article  PubMed  Google Scholar 

  9. Gasparyan AY, Stavropoulos-Kalinoglou A, Mikhailidis DP, Toms TE, Douglas KM, Kitas GD (2010) The rationale for comparative studies of accelerated atherosclerosis in rheumatic diseases. Curr Vasc Pharmacol 8:437–449

    Article  PubMed  CAS  Google Scholar 

  10. Asmar R (2007) Effects of pharmacological intervention on arterial stiffness using pulse wave velocity measurement. J Am Soc Hypertens 1:104–112

    Article  PubMed  Google Scholar 

  11. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  12. Kim HJ, Nam JS, Park JS, Cho M, Kim CS, Ahn CW et al (2009) Usefulness of brachial-ankle pulse wave velocity as a predictive marker of multiple coronary artery occlusive disease in Korean type 2 diabetes patients. Diabetes Res Clin Pract 85:30–34

    Article  PubMed  Google Scholar 

  13. Ku IA, Imboden JB, Hsue PY, Ganz P (2009) Rheumatoid arthritis: a model of systemic inflammation driving atherosclerosis. Circ J 73:977–985

    Article  PubMed  CAS  Google Scholar 

  14. Rhee SY, Guan H, Liu ZM, Cheng SW, Waspadji S, Palmes P et al (2007) Multi-country study on the prevalence and clinical features of peripheral arterial disease in Asian type 2 diabetes patients at high risk of atherosclerosis. Diabetes Res Clin Pract 76:82–92

    Article  PubMed  Google Scholar 

  15. van Halm VP, Peters MJ, Voskuyl AE, Boers M, Lems WF, Visser M et al (2009) Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE investigation. Ann Rheum Dis 68:1395–1400

    Article  PubMed  Google Scholar 

  16. Lim JH, Kim YK, Kim YS, Na SH, Rhee MY, Lee MM (2010) Relationship between serum uric acid levels, metabolic syndrome, and arterial stiffness in Korean. Korean Circ J 40:314–320

    Article  PubMed  CAS  Google Scholar 

  17. Tanaka K, Inaba M, Goto H, Nagata-Sakurai M, Sakai S, Yamada S et al (2006) Paraarticular trabecular bone loss at the ultradistal radius and increased arterial stiffening in postmenopausal patients with rheumatoid arthritis. J Rheumatol 33:652–658

    PubMed  Google Scholar 

  18. Inaba M, Tanaka K, Goto H, Sakai S, Yamada S, Naka H et al (2007) Independent association of increased trunk fat with increased arterial stiffening in postmenopausal patients with rheumatoid arthritis. J Rheumatol 34:290–295

    PubMed  Google Scholar 

  19. Provan SA, Angel K, Semb AG, Mowinckel P, Agewall S, Atar D et al (2011) Early prediction of increased arterial stiffness in patients with chronic inflammation: a 15-year followup study of 108 patients with rheumatoid arthritis. J Rheumatol 38:606–612

    Article  PubMed  Google Scholar 

  20. Mäki-Petäjä KM, Hall FC, Booth AD, Wallace SM, Yasmin S, Bearcroft PW et al (2006) Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 114:1185–1192

    Article  PubMed  Google Scholar 

  21. Wong M, Oakley SP, Young L, Jiang BY, Wierzbicki A, Panayi G et al (2009) Infliximab improves vascular stiffness in patients with rheumatoid arthritis. Ann Rheum Dis 68:1277–1284

    Article  PubMed  CAS  Google Scholar 

  22. Zacho J, Tybjaerg-Hansen A, Jensen JS, Grande P, Sillesen H, Nordestgaard BG (2008) Genetically elevated C-reactive protein and ischemic vascular disease. N Engl J Med 359:1897–1908

    Article  PubMed  CAS  Google Scholar 

  23. Tso TK, Huang WN, Huang HY, Chang CK (2005) Association of brachial-ankle pulse wave velocity with cardiovascular risk factors in systemic lupus erythematosus. Lupus 14:878–883

    Article  PubMed  CAS  Google Scholar 

  24. Ruyssen-Witrand A, Fautrel B, Saraux A, Le Loët X, Pham T (2011) Cardiovascular risk induced by low-dose corticosteroids in rheumatoid arthritis: a systematic literature review. Joint Bone Spine 78:23–30

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Kim HK, Research Nurse, for collection of clinical data. This work was supported by a grant from Korea Institute of Medicine.

Conflict of interest

There are no conflicts of interest related to the manuscript.

Author information

Authors and Affiliations

  1. Hanyang University Hospital for Rheumatic Diseases, 17 Haengdang-Dong, Sungdong-Gu, Seoul, 133-792, Republic of Korea

    Young-Sam Kim, Yoon-Kyoung Sung, Chan-Bum Choi, Wan-Sik Uhm, Tae-Hwan Kim & Jae-Bum Jun

  2. Division of Cardiology, Department of Internal Medicine, Hanyang University Hospital, 17 Haengdang-Dong, Sungdong-Gu, Seoul, Republic of Korea

    Jin-Ho Shin

Authors
  1. Young-Sam Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoon-Kyoung Sung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chan-Bum Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wan-Sik Uhm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tae-Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin-Ho Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jae-Bum Jun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jae-Bum Jun.

Additional information

Young-Sam Kim and Yoon-Kyoung Sung equally contributed to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, YS., Sung, YK., Choi, CB. et al. The major determinants of arterial stiffness in Korean patients with rheumatoid arthritis are age and systolic blood pressure, not disease-related factors. Rheumatol Int 32, 3455–3461 (2012). https://doi.org/10.1007/s00296-011-2198-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2198-y

Keywords

Search

Navigation